Evaluation of the International Study Group of Pancreatic Surgery definition of post-pancreatectomy hemorrhage in a high-volume center

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Robert Grützmann - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Felix Rückert - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Nele Hippe-Davies - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Marius Distler - , Department of Visceral, Thoracic and Vascular Surgery, National Center for Tumor Diseases Dresden, University Hospital Carl Gustav Carus Dresden (Author)
  • Hans Detlev Saeger - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)

Abstract

Background: Although postpancreatectomy hemorrhage (PPH) is observed infrequently after pancreatic surgery, it remains a serious complication with a high rate of mortality. Recently, the International Study Group of Pancreatic Surgery (ISGPS) issued a new definition for PPH. To evaluate and validate this new definition, we analyzed data retrospectively from our center. Methods: Data from 945 patients who underwent pancreatic surgery in our department between October 1993 and December 2009 were identified retrospectively from our prospective database with regard to the occurrences of PPH. We graded the hemorrhages recorded in our database according to the ISGPS consensus definition. We assessed the clinical course, morbidity, mortality, and duration of hospital stay for patients with grade B and C PPHs in comparison with patients who underwent pancreatic resections without hemorrhage. Results: Grade B PPH after pancreatic surgery occurred in 16 patients (1.7%), and grade C PPH occurred in 38 patients (4.0%). Mortality was significantly increased in PPH grades B and C compared with control patients (25.9% vs 2.0%; P <.001) and contributed to nearly one-half of the mortality in the present series. Morbidity was also increased in patients with grade B (76.5%) and C (94.6%) PPH compared with control patients (59.6%; P <.001). Grade B and C PPH correlated significantly with the incidence of grade C postoperative pancreatic fistula (14.8% vs 1.9%), grade C delayed gastric emptying (18.5% vs 4.0%), and wound infection (38.9% vs 13.5%) compared with control patients. Conclusion: This is the first clinical evaluation of the ISGPS PPH definition. Our data indicate that the new definition correlates well with morbidity, mortality, and duration of hospital stay. The definition, therefore, seems suitable for clinical and scientific applications.

Details

Original languageEnglish
Pages (from-to)612-620
Number of pages9
JournalSurgery
Volume151
Issue number4
Publication statusPublished - Apr 2012
Peer-reviewedYes

External IDs

PubMed 22088819

Keywords

ASJC Scopus subject areas